A booming global industry, human blood, and an Albany strip mall

Hannaford Plaza Albany empty space 2018-June

The blood coursing through all our veins -- or, specifically, a portion of that blood -- has become a key component in a booming industry.

Products made from blood plasma are worth more than $100 billion annually worldwide. Much of that plasma comes from the United States. It's used both here and abroad for all sorts of life-saving treatments.

Now that global industry is looking to expand to... a strip mall in Albany.

And that's prompted some concerns.

What is blood plasma? How is it collected?

A quick refresher from biology class: Plasma is the liquid portion of blood, and it makes up a little more than half of the volume in a given unit of whole blood. It's almost completely made up of water. But the little bit that's not includes proteins that can be turned into therapies for people suffering from trauma, burns, conditions such as hemophilia, and various diseases.

Plasma is collected much the same way that whole blood is -- via a needle in the arm. A machine draws in the whole blood and then separates the red blood cells from the plasma. Those cells are then returned to the body and the plasma stays collected. (The technical term for this process is plasmapheresis.)

bag of blood plasma credit Wikipedia user DiverDave CC
One unit of plasma. The color of plasma is often called "straw." / photo: Wikipedia user DiverDave (CC BY-SA 3.0)

Companies can pay for it?

Unlike blood donations, companies pay donors for collecting plasma. Representatives of a company called CSL Plasma told the Albany planning board during a June 11 workshop session that donors typically are given about $40 for each collection session.

This STAT article looks at some of the historical and technical reasons for why that is. But the short explanation is the products made from plasma can be processed to remove diseases in ways that whole blood can't be, which mitigates some of the concerns about people lying or otherwise not being forthcoming when being screened as donors. (Potential donors still go through a screening process, and the CSL reps said during the planning board workshop that only about a third of applicants make it through the screen.) The feds allow donors to give plasma twice a week as along as donors weigh at least 110 pounds.

Still, that prompts some ethical questions because most people aren't going to be willing to spend an hour or so with a needle stuck in their arm for $40*. So donors tend to really need the money, such as people struggling to pay for living expenses and college students. The CSL reps said at that workshop that college students are a key donor market for them. (* Which is often paid on a gift card-style debit card, a practice that its own complications.)

And those economically vulnerable people are contributing to a huge global trade.

This is a booming, global business

The global market for blood plasma exports was $126 billion in 2016, as The Economist recently noted in a profile of the industry and debates about paying for plasma donations. In part because it allows paid donations, the United States is the world's major supplier. (The head of a network of blood banks once referred to the US as "the OPEC of plasma.")

The industry is dominated by a handful of large international corporations. From a recent consultancy report abstract: the "competitive landscape of the market is of oligopoly form". CSL is one of these companies.

And worldwide demand for the therapeutic products derived from plasma continues to grow. So, too, has the number of plasma collection centers in the United States.

What this all has to do with Albany

Albany proposed plasma center use districts 2018-June
The areas of the city where plasma collection centers would be allowed. (click the image for a larger view)

There are currently just a few active plasma collection centers in New York State, according to an online FDA license database: A CSL center in Greece, just outside of Rochester, and one operated by KED Plasma (another industry giant) in Williamsville, near Buffalo. But CSL has big plans for expansion in New York. Its website notes nine "coming soon" sites across the state, including Schenectady and Albany.

And that leads to the specific situation in Albany. CSL Plasma has been working for roughly the past year to open a plasma collection center in a vacant storefront space at the Hannaford Plaza on Central Ave.

Plasma collection center doesn't neatly fit into the city's existing zoning, so the project went before the city's Board of Zoning Appeals last fall trying to get some sort of ruling that would open the way for it. (The BZA declined.) And now the city is looking at creating use-specific standards in its zoning code to allow plasma collection centers.

Specifically, the city's planning department has laid out a set of rules that would make a plasma center a conditional use in a handful of zones (see the map above). The standards, from a planning department memo:

1. Facilities must be at least 250 feet from the nearest boundary line of a lot with a Household Living use; a Group Living use, a Religious Institution; or a School.
2. All equipment, samples, and products must be stored inside the building;
3. Facilities must provide and follow a management plan for handling litter, outdoor queuing, security and loitering;
4. Facilities shall include waiting and departure lounge sufficient in size, but a minimum of five hundred (500) square feet, to accommodate all scheduled donors within one hour prior to their appointment and one hour after, as well as any anticipated drop-in patrons. Such waiting areas shall include restroom facilities and be open at least on hour prior to the opening of the center for business for the use of waiting patrons.

Chris Spencer, the city's planning and development commissioner, said the rules were initially shaped in part by the city's experiences with methadone clinics, which popped up as part of a broader zoning category and have since prompted complaints about loitering and double parking. (The city is also moving to adopt specific zoning standards for methadone clinics.)

"We want to make sure that [plasma centers] have sufficient room in the waiting room so there weren't people milling outside and make sure that people would be taken care of after they've taken gotten their treatment or made their donation," Spencer said after last Thursday's planning board meeting. "We want to make sure all of those things were taken [into account], that the building itself was sufficient that it wasn't some place on a street where people are going to be double parked as they were dropping off and loading."

Hannaford Plaza Albany corner 2018-June

Skepticism and pushback

But the new rules have gotten pushback, primarily from Common Council member Michael O'Brien, for not being restrictive enough.

O'Brien has been critical of setting the buffer between plasma centers and residential areas / churches / schools at 250 feet. He points to the initial rules first floated by the planning department last year that set the buffer at 1,000 feet.

"Does it have to be a thousand feet? I don't know if that's the magic number," O'Brien said at the planning board workshop earlier this month. "But why is it suddenly spinning it at 250 now when they already decided the thousand for methadone, 500 for marijuana dispensary. Why has it now magically [become] 250 with this one. Why isn't it more the 500 or 750 range?"

O'Brien seems skeptical of the industry generally. His response when we asked about the possible perception that pushback on these sorts of facilities was about trying to keep poor people out of an area: "No, this is victimizing poor people. That's what I think it is. And it isn't just for that location. This regulation applies to the whole city."

Albany planning board 2018-06-21 O'Brien comment

O'Brien was joined by five residents expressing opposition or skepticism to the new rules during public comments as part of public hearing at last week's planning board meeting. They said they were concerned about effects on residential areas, and pointed to crime and other disruptions at plasma centers in news reports from other parts of the country.

Common Council member Judy Doesschate also spoke, noting she thought it was unfair that CSL was allowed to make an informational presentation about its business at the planning board workshop but residents weren't allowed to speak to the specific site because the hearing was about the standards generally.

And during his comment O'Brien questioned the change of the buffer zone, questioned the work the planning department had done to determine the size of the buffer, and alleged the whole process was violating rules of procedure.

That's when things got a bit testy -- board chair Al DeSalvo said he took exception to the last allegation. And then O'Brien got upset when an attorney from Whiteman Osterman & Hanna -- who was there to represent CSL -- got the chance to speak last during the public comment. (O'Brien had requested that spot, a courtesy often afforded to council members. The planning staff member coordinating the speakers list said the order had just gotten mixed up.) O'Brien then left the meeting during the attorney's comments.

Albany planning board 2018-06-21 O'Brien objection

Tabled

The actual power to change the city's zoning rests with the Common Council. And the item up before the planning board during the public hearing was a recommendation to the council. (It's essentially a formal opinion.)

After all the back and forth, planning board member Christopher Ellis moved to table the question. And board member Roman Kuchera seconded it, noting he'd like the board to get advice from the city's attorneys. And chair Al DeSalvo recommended the board seek input from the state Department of Health.

The board voted unanimously to table the question.

After the meeting, Chris Spencer said the 1,000-foot buffer was initially proposed because of the concurrent effort to regulate methadone dispensaries.

"Then as we learned more and more about these donation centers, we became more and more comfortable with the impacts and felt that the use-specific standards that we had were sufficient to deal with any kind of impacts that might be," Spencer said. "So the 1000 feet in retrospect probably would've been an overreach. I don't know that there are too many other communities, the ones that we looked at, that they could even find a thousand. There may be one or two. But generally most of them were not done under a separate use. Most of them had no limitations in terms of the radius around them -- when they did they were in the range of I think 200 to 500."

"We don't like to zone things just because there's no harm in making it more difficult for something. Our zoning is very specific in terms of we want to find out what the impacts are, if there are any impacts, and we prefer to use specific standards around those. We don't try to create things that are just in case."

And why not just set the buffer at 1,000 feet, just in case?

"Well, I think what you do then is you're putting [plasma collection centers] potentially in places where they're not on a bus line, where they're not in an area that's walkable, where the people that benefit from some of the income that's derived from this, from their time in the donation, wouldn't have that ability," he said. "We don't like to zone things just because there's no harm in making it more difficult for something. Our zoning is very specific in terms of we want to find out what the impacts are, if there are any impacts, and we prefer to use specific standards around those. We don't try to create things that are just in case."

Spencer said the board was following the procedures in the zoning code for holding a public hearing about the recommendation, and the final decision will be in the hands of the Common Council. He also said the department will continue to research the topic and it will look at putting together some sort of report about its conclusions.

Comments

There are many medical office parks accessible by public transportation where a facility of this nature could be located. A strip mall with Grocery store and restaurants seems inappropriate from a bio-hazard aspect.

Bio-hazard? Well, Red Cross blood drives are often held IN schools and churches, not 250-1000 ft. from them. How is that different? Surely there are protocols in places for this kind of bio-hazard. Seems like the difference is that middle class people are often the donors at the Red Cross sites, whereas low income people are the main clients selling their plasma at a plasma collection center. It shouldn't matter. My professional sister (an oral pathologist) was recently recalling how she sold her plasma a number of times decades ago to help pay the bills while she was in school. She was glad to have the option to earn a pretty good payment for an hour's time. Are these people selling their plasma "victims"? All wage slaves under capitalism can be considered exploited labor for the prevailing low minimum wage, but this has the benefit of informed consent and $40 an hr. I do wish a billion dollar industry paid more, but I don't think the good burghers of Albany actually care about that. I'll probably continue to do my (free) blood product donations through the Red Cross, but, hey, if the federal gov't messes with my Social Security, you might see me on line.

is this considered a laboratory? or a blood bank of some kind?

Any mental gymnastics to make sure that the desperately poor aren't seen or heard. If a strip mall can hold something like a Labcorp or a Quest Diagnostics for medical testing it surely can hold a blood plasma donation center. As another comment noted, every blood drive I've ever been to was inside of a school!

We should stop paying heed to NIMBYs who would like to pretend poverty doesn't exist. It DOES and when you work a minimum wage selling plasma is an enormous boost to income (ethical issues of selling your body aside). Full-time work on minimum wage in NY today gives you a little shy of $200. One can donate blood plasma a max of 2x per week. That's boosting your income by almost 50%!!!

We're suddenly concerned about double parking in this plaza? And thank heavens we have these people looking out for poor people. As we all know they can't possibly make a decision on this without a politician.

So much pearl clutching but it keeps the lobbyists in business right?

I honestly don't get all the pearl clutching on this one. It seems much more like a Labcorp bloodwork center than a porn shop, but they are treating it like the latter.

Vampires seem to be the new growth industries here in the beautiful Capital Region of upstate NY. A Casino to extract your cash, plasma centers for your actual life blood, tax dollars sucked to feed the connected(Kalyeros,Cuomo,TechValley). I could go on and on. Anyone else out there feel that this could be a sign that we should probably get our $#!+ together and fight for a better system. Well the good news is that you could pretty much buy a majority of the South End of Albany from our benevolent County Govt for less than a house and 2 cars in the upscale suburbs . Thank you All Over Albany for keeping us informed unlike the local News Media.

Who wouldn't value the rich cultural exchange opportunities afforded by having such a facility located in their neighborhood?

I actually really want this to happen. I've been frustrated with not being able to sell my plasma locally. I work full time and have decent benefits but the extra money to help pay down my debt would be wonderful.

Sean, I'm curious where you get the figures: "Full-time work on minimum wage in NY today gives you a little shy of $200." I believe minimum wage for upstate New York is currently $10.40. If we consider full time work to be 8 hours a day for 5 days a week, the gross weekly pay for a person earning minimum wage would be $416, or a gross bi-weekly rate of $832. If a person earning minimum wage were to donate plasma twice a week, that would be $80, or $160 bi-weekly, an increase of just over 19%, not 50%. Obviously, a 19% pay raise is significant, but let's at least get our numbers right. Further discussion should focus on exactly how many people would benefit from this, how many people really are on minimum wage or living on less somehow, and what the concerns are regarding these kinds of centers.

@Ra -- in a free market, if there aren't enough people willing to sell their plasma, these for-profit plasma centers will close and go elsewhere.

And while my info is anecdotal, I know a lot of people in low paying retail jobs who can't get full time hours because the employer does not want to grant full time benefits. I believe there is a lot of underemployment among those earning minimum wage. Yet they have bills to pay and often have student loan debt. I am not entirely sure how much discussion and "focus" (by the city) is necessary to determine if there are enough potential plasma "donors" ("sellers" to be more accurate) to make it worth opening one of these sites. Presumably CSL Plasma has determined to its satisfaction that it are. Sometimes more studying of an issue is just obstructionism.

Hi Chrisck, I’m sure you’re right about the abundance of potential “suppliers”. I don’t have those numbers myself so that would be interesting to know what went into that determination. I would point out that your comment didn’t address any other points made, only the point about how many people would use it. Since I don’t know too much about such centers, I would ask you or perhaps someone who knows more about it what the other concerns are. How legitimate are bio-hazard concerns? Why are there distance restrictions? I think the discussion is important to have and fully understanding an issue is critical before making a determination. I don’t think we’ve reached the “obstructionism” point yet.

Ra, I wouldn't expect biohazard concerns to be more significant than at a vet or bloodwork lab, and I don't see huge public concerns around those.

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